| NPI | 1942774955 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRONDA LANAE' JACKSON Psychotherapist 803-814-7115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251B00000X Case Management |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 251S00000X | |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |